Mitigating Risk Factors for Alzheimer’s Disease Earlier

November is National Alzheimer’s Awareness Month. The general public’s perception of the disease is that it only affects the elderly and that the risk factors for dementia begin in later years. Most patients do not change behavior even in their forties to protect their future cognitive health. But modifiable risk factors for Alzheimer’s exist for people of all ages.

This year, general outreach continues to ensure everyone learns about the many risk factors that reduce dementia risk.  However, Alzheimer’s Awareness Month 2020 includes a new emphasis on modifying behaviors in early childhood.

Mitigating the Risk Factors for Alzheimer’s Earlier

Alzheimer’s disease researchers continue to explore preventative measures begun even decades prior to any dementia symptoms. Only very recently has research attention turned to early age as a point at which intervention must begin. 

Although early-life cognitive enrichment showed a direct association with Alzheimer’s disease neuropathology, as shown in previous reports from the Nun Study, the current work by the Rush Memory and Aging Project, with a larger, more diverse cohort demonstrates that most of the cognitive benefits associated with early-life cognitive enrichment were independent of classic Alzheimer’s disease neuropathology (80% direct effect on cognition).

A broad range of early-life mental stimulation, such as acquiring multilingual skills, mathematics, and other cognitive stimulation activities have been correlated with a reduced rate of dementia. Physically / mentally active lifestyles have also been linked with reduced late-life cognitive decline. And many studies show that mental engagement activities may help slow brain aging in the elderly.

Limits of Research into Early-Age Risk Factors for Alzheimer’s

This research does have limitations. Participants’ may have incomplete recollections or reports of early childhood enrichment. Tracking the consistency of timing, dose, and duration of enrichment throughout their life spans presents a challenge.  And although environmental enrichment can improve cognitive decline in aging models of Alzheimer’s, such models do not reflect the congenital and clinical heterogeneity present, which can affect early-life cognitive enrichment.

Importance of Cognitive Assessment for All Ages

Despite the limitations, these findings carry important public health implications. They suggest that providers could prevent late-life cognitive decline through careful and deliberate changes to public policy involving early-life enrichment. Salient factors could include socioeconomic status in early life, cognitively stimulating activities by six years old, availability of resources by 12 years old, and to some extent, early life second-language learning.

This research also points to the need for earlier cognitive assessment and intervention. Objective measurements of cognitive function could provide better insight than less reliable subjective recollection. And to prevent future cognitive impairment, pediatric and primary care providers need to consider early life cognitive enrichment in wellness regimens, especially when other risk factors are present.

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